The Cat House on the Kings
Surrender Form
7120 S. Kings River Rd., Parlier, CA 93648-9720 • (559) 638-8696

Please note:

We require evidence from a veterinarian that your cat has been tested for FeLV and FIV so that we can provide proper care.
This test must be repeated if your cat has either been outside or exposed to other cats who are FeLV+ or FIV+ since this test was done.

We require every surrendered cat to be microchipped.
A $10 fee will be added to the deposit if the cat needs to be microchipped on arrival.

Not all cats will do well in the sanctuary environment.

The transition into the sanctuary is especially stressful for older, extremely timid and/or obese cats, to the extent that they may suffer significant health issues. We cannot guarantee their continued well-being. Therefore, the sanctuary should be the very last resort for these particular cats. We will gladly work with you to find an alternative which may be better for the cat.

I am

an individual

representing a rescue group

Rescue group:

For individuals the
total charge to surrender a cat is $5000. As a courtesy and only if you live in California, we will accept monthly payments toward this total, provided that you have first paid a non-refundable deposit of $500 (for cats under 8 years old) and $1000 for senior cats (8 years and older).
The minimum monthly payment for non-senior cats is $60 per month until the entire balance is paid (up to 83 months) and $75
per month for senior cats (up to 67 months).
If the cat is unvaccinated or unaltered, there is an $80 fee in addition to the deposit.

Note: The full surrender fee is due and payable to The Cat House on the Kings even if the cat dies before full payment has been made. If the cat is adopted
before all payments have been made, The Cat House on the Kings will consider the remaining debt to be paid in full and no further payments will be required.

Payment in full discount: If you pay the entire surrender fee at the time the cat is surrendered,
the surrender fee will be discounted 10%. e.g. For a non-senior cat the discounted fee would then be $4500.

The surrender fee is NOT tax-deductible because we are providing the service of lifetime care for the surrendered cat in exchange for the fee.

Are you willing to pay the surrender fee?

Yes

No

How will you pay?

PayPal (Auto. & Preferred)

Automatic Bank Draft

Monthly Check

One Check

First name:

Last name:

E-mail:

Home phone:

Cell phone:

Work phone:

Address:

City:

State:

Zip:

Workplace:

Work Address:

City:

State:

Zip:

Nearest Relative/Friend NOT LIVING WITH YOU #1:

Address:

City:

State

Zip:

Phone:

Nearest Relative/Friend NOT LIVING WITH YOU #2:

Address:

City:

State

Zip:

Phone:

Is this cat

Your pet?

Stray?

Other?

Why can't you keep this cat?

If not your pet, where did this cat come from?

Did you try to find the cat's owner?

Yes

No

Name of cat:

Date of birth (est.)

Microchip ID:

Gender:

Male

Female

Breed:

Color:

Veterinarian (if your pet):

Spayed/neutered?

Yes

No

Don't know

All cats entering the sanctuary must be tested for the Feline Leukemia Virus (FeLV) and the Feline Immunodeficiency Virus (FIV). This is usually done with a single combination test.

Has this cat been tested for FeLV/FIV?

Yes

No

FeLV/FIV test date:

FeLV:

Positive

Negative

FIV:

Positive

Negative

Has the cat been outside since the FeLV/FIV test?

Yes

No

Has the cat had unsupervised contact with any FeLV+ / FIV+ cat since the FeLV/FIV test?

Yes

No

The following conditions apply when a cat is surrendered without first being tested for FeLV/FIV:

The cat will be isolated until an FeLV/FIV test can be performed.

There will be an additional charge to perform the test at the sanctuary. Contact us for the current cost.

If the cat cannot be handled, he/she may need to be sedated to perform the test. Sedation carries an inherent risk to the cat.

If the cat is FeLV+ you will be notified immediately and then have seven (7) days in which to take the cat back after which time he/she will be humanely euthanized. The Cat House on the Kings has no facility to care for FeLV+ cats.

If the cat is FIV+, our acceptance of the cat will depend on the capacity of our FIV ward. If we cannot accommodate the cat in the FIV ward, you will be notified immediately and then have seven (7) days in which to take the cat back after which time he/she will be humanely euthanized.

If the cat is euthanized either for testing FeLV+ or FIV+ when our FIV ward is full, or dies under sedation for the FeLV/FIV test, your obligations under this surrender agreement remain in effect. Therefore it is in your best interest to ensure that the test is performed before surrendering the cat.

I understand and accept these conditions for surrendering a cat not tested for FeLV/FIV.

Current on vaccinations?

4 in 1 (FVRCP & C):

Yes

No

Don't know

(All surrenders should have a 4 in 1 booster within 9 months of surrender if possible.)

Leukemia:

Yes

No

Don't know

Rabies:

Yes

No

Don't know

Please tell us as much as you can about this cat:

I understand and agree that upon surrender I relinquish all rights and claims to this cat.

I confirm that I have contacted Lynea to obtain approval.

I understand that the surrender fee is not tax-deductible.

I understand that the deposit is non-refundable.

I understand and accept that not all cats will do well in the sanctuary environment.

I understand that given the number of cats and the size of the property, The Cat House on the Kings staff are not able to provide photos or updates on the condition of any surrendered cat on demand. However, I understand that I can schedule a visit to find the cat and check on him/her myself.

I understand that The Cat House on the Kings may not accept this cat if the name and photo(s) I have provided are insufficient to distinguish this cat from similar cats.

Our rescue group would like to participate in the Exchange Program and we agree to the program terms and conditions.

Our rescue group has received written approval to participate in the Exchange Program.

If you default on this agreement, we reserve the right to return your cat/cats either to your residence or to your relative/friend's residence or to take legal action against you.

By initialing all the boxes above and signing below, I affirm that I have read, understood and agree to the conditions set forth in this agreement.

Signature

Date

IN WITNESS WHEREOF the parties hereto have executed these presents the day and year above written.